Mexico: Swine Flu Deaths Spur Global Epidemic Fears

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MEXICO CITY – A unique strain of swine flu is the suspected killer of dozens of people in Mexico, where authorities closed schools, museums, libraries and theaters in the capital on Friday to try to contain an outbreak that has spurred concerns of a global flu epidemic.

The worrisome new virus — which combines genetic material from pigs, birds and humans in a way researchers have not seen before — also sickened at least eight people in Texas and California, though there have been no deaths in the U.S.

"We are very, very concerned," World Health Organization spokesman Thomas Abraham said. "We have what appears to be a novel virus and it has spread from human to human ... It's all hands on deck at the moment."

The outbreak caused alarm in Mexico, where more than 1,000 people have been sickened. Residents of the capital donned surgical masks and authorities ordered the most sweeping shutdown of public gathering places in a quarter century. President Felipe Calderon met with his Cabinet Friday to coordinate Mexico's response.

The WHO was convening an expert panel to consider whether to raise the pandemic alert level or issue travel advisories.

It might already be too late to contain the outbreak, a prominent U.S. pandemic flu expert said late Friday.

Given how quickly flu can spread around the globe, if these are the first signs of a pandemic, then there are probably cases incubating around the world already, said Dr. Michael Osterholm at the University of Minnesota.

In Mexico City, "literally hundreds and thousands of travelers come in and out every day," Osterholm said. "You'd have to believe there's been more unrecognized transmission that's occurred."

There is no vaccine that specifically protects against swine flu, and it was unclear how much protection current human flu vaccines might offer. A "seed stock" genetically matched to the new swine flu virus has been created by the U.S. Centers for Disease Control, said Dr. Richard Besser, the agency's acting director. If the government decides vaccine production is necessary, manufacturers would need that stock to get started.

Authorities in Mexico urged people to avoid hospitals unless they had a medical emergency, since hospitals are centers of infection. They also said Mexicans should refrain from customary greetings such as shaking hands or kissing cheeks. At Mexico City's international airport, passengers were questioned to try to prevent anyone with flu symptoms from boarding airplanes and spreading the disease.

Epidemiologists are particularly concerned because the only fatalities so far were in young people and adults.

The eight U.S. victims recovered from symptoms that were like those of the regular flu, mostly fever, cough and sore throat, though some also experienced vomiting and diarrhea.

U.S. health officials announced an outbreak notice to travelers, urging caution and frequent handwashing, but stopping short of telling Americans to avoid Mexico.

Mexico's Health Secretary Jose Angel Cordoba said 68 people have died of flu and the new swine flu strain had been confirmed in 20 of those deaths. At least 1,004 people nationwide were sick from the suspected flu, he said.

The geographical spread of the outbreaks also concerned the WHO — while 13 of the 20 deaths were in Mexico City, the rest were spread across Mexico — four in central San Luis Potosi, two up near the U.S. border in Baja California, and one in southern Oaxaca state.

Scientists have long been concerned that a new flu virus could launch a worldwide pandemic of a killer disease. A new virus could evolve when different flu viruses infect a pig, a person or a bird, mingling their genetic material. The resulting hybrid could spread quickly because people would have no natural defenses against it.

Still, flu experts were concerned but not alarmed about the latest outbreak.

"We've seen swine influenza in humans over the past several years, and in most cases, it's come from direct pig contact. This seems to be different," said Dr. Arnold Monto, a flu expert with the University of Michigan.

"I think we need to be careful and not apprehensive, but certainly paying attention to new developments as they proceed."

The CDC says two flu drugs, Tamiflu and Relenza, seem effective against the new strain. Roche, the maker of Tamiflu, said the company is prepared to immediately deploy a stockpile of the drug if requested.

Both drugs must be taken early, within a few days of the onset of symptoms, to be most effective.

Cordoba said Mexico has enough Tamiflu to treat 1 million people, but the medicine will be strictly controlled and handed out only by doctors.

Mexico's government had maintained until late Thursday that there was nothing unusual about the flu cases, although this year's flu season had been worse and longer than past years.

The sudden turnaround by public health officials angered many Mexicans.

"They could have stopped it in time," said Araceli Cruz, 24, a university student who emerged from the subway wearing a surgical mask. "Now they've let it spread to other people."

The city was handing out free surgical masks to passengers on buses and the subway system, which carries 5 million people each day. Government workers were ordered to wear the masks, and authorities urged residents to stay home from work if they felt ill.

Closing schools across Mexico's capital of 20 million kept 6.1 million students home, as well as thousands of university students. All state and city-run cultural activities were suspended, including libraries, state-run theaters, and at least 14 museums. Private athletic clubs closed down and soccer leagues were considering canceling weekend games.

The closures were the first citywide shutdown of public gathering places since thousands died in the devastating 1985 earthquake.

Mexico's response brought to mind other major outbreaks, such as when SARS hit Asia. At its peak in 2003, Beijing shuttered schools, cinemas and restaurants, and thousands of people were quarantined at home.

In March 2008, Hong Kong ordered more than a half-million students to stay home for two weeks because of a flu outbreak. It was the first such closure in Hong Kong since the outbreak of SARS, or severe acute respiratory syndrome.

"It's great they are taking precautions," said Lillian Molina, a teacher at the Montessori's World preschool in Mexico City, who scrubbed down empty classrooms with Clorox, soap and Lysol between fielding calls from worried parents.

U.S. health officials said the outbreak is not yet a reason for alarm in the United States. The five people sickened in California and three in Texas have all recovered.

It's unclear how the eight, who became ill between late March and mid-April, contracted the virus because none were in contact with pigs, which is how people usually catch swine flu. And only a few were in contact with each other.

CDC officials described the virus as having a unique combination of gene segments not seen before in people or pigs. The bug contains human virus, avian virus from North America and pig viruses from North America, Europe and Asia. It may be completely new, or it may have been around for a while and was only detected now through improved testing and surveillance, CDC officials said.

The most notorious flu pandemic is thought to have killed at least 40 million people worldwide in 1918-19. Two other, less deadly flu pandemics struck in 1957 and 1968.

____

Associated Press Writers Maria Cheng in London; Traci Carl in Mexico City; Mike Stobbe in Atlanta, Georgia; and Malcolm Ritter in New York contributed to this report.
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Mexico swine flu deaths spur global epidemic fears
 
Mexico warns no kissing as 81 dead in swine flu outbreak

(CNN) -- No kissing to say hello. No large crowds. No close contact.

That's the advice of the Mexican government as more and more people die of swine flu, which has turned into a "public health emergency of international concern," according to the World Health Organization.

The WHO advised all countries to be on the lookout for "unusual" outbreaks of flu, following an emergency meeting Saturday as the seriousness of the outbreak became clear.

By Sunday, 81 deaths had been deemed "likely linked" to a deadly new strain of the virus by health authorities in Mexico. Viral testing has confirmed 20 cases, said Dr. Jose A. Cordova Villalobos, Mexico's health secretary.

In Mexico City, the massive downtown Cathedral of Mexico City was open but Masses were not scheduled. Dozens of worshippers put on masks and went inside the church anyway to pray on their own.

The H1N1 strain of swine flu is usually associated with pigs. When the flu spreads person-to-person, instead of from animals to humans, it can continue to mutate, making it a tougher strain that is harder to treat or fight off.

Symptoms of swine flu include fever, lethargy, lack of appetite, coughing, runny nose, sore throat, nausea, vomiting and diarrhea, according to the CDC.

In the United States, the number of confirmed swine flu cases stood at 11. President Obama recently returned from a trip to Mexico, but has not shown any signs of flu-like symptoms, the White House said.

But in New Zealand, officials said 22 students and three teachers back from a three-week-long language trip to Mexico may have been infected with the swine flu virus.

The 25 students and teachers at Auckland's Rangitoto College returned to New Zealand via Los Angeles on Saturday.

Fourteen have shown flu-like symptoms, with four "more unwell than others," said Dr. Julia Peters, clinical director of Auckland Regional Public Health Service. It is not clear whether anyone else who was on the plane with them has shown signs of the disease.

Health Minister Tony Ryall said 10 students tested positive for influenza A. The specimens will be sent to WHO to determine whether it is H1N1 swine influenza.

H1N1 influenza is a subset of influenza A. The WHO results are expected back by midweek. The group remains quarantined at home.

"It certainly has not been confirmed that they have swine flu," said Dr. Craig Thornley of Auckland Regional Public Health Service. "We already have provisional information that some of the group have influenza A. We won't know if they have the type of influenza A that is swine flu."

A British Airways crew member developed flu-like symptoms during a flight from Mexico City to London and was tested for swine flu, but the results came back negative.

"I can confirm that the patient doesn't have swine flu," said Jonathan Street, a spokesman for Northwick Park Hospital in north London. "We have done all tests, and they all came back negative."

The flight attendant is back at work, British Airways told CNN.

Britain is not putting travel restrictions in place, according to British Airways and Heathrow airport operator BAA, and the country's Port Health Authority has no reason for concern over swine flu, BAA said.

The Mexico Tourist Board said Saturday there are no restrictions on travel to the country.

In Israel, doctors are running tests on a man who recently returned from Mexico with light flu symptoms.

U.S. health officials said Friday that some cases of the virus in the United States matched samples of the deadly Mexican virus.

All the patients have recovered or are expected to.

The panic over the virus prompted Canada to issue a travel health notice, saying the public health agency was "tracking clusters of severe respiratory illness with deaths in Mexico."

South Korea said it will test airline passengers arriving from the United States. Japan will convene a Cabinet meeting Monday to develop measures to block entry of the virus into the country.

The United States has not issued any travel warnings or quarantines.

But US Airways said Saturday it would allow passengers to change plans if they wanted to because of the outbreak.

Airline spokeswoman Michelle Mohr said it was not asking people not to travel to Mexico, but wanted to "give them that flexibility" if "they don't feel comfortable."

Gregory Hartl of the World Health Organization said the strain of the virus seen in Mexico is worrisome because it has mutated from older strains.

"Any time that there is a virus which changes ... it means perhaps the immunities the human body has built up to deal with influenza might not be adjusted well enough to deal with this new virus," Hartl said.

Mexico City has closed all of its schools and universities until further notice because of the virus.

Mexico warns no kissing as 81 dead in swine flu outbreak - CNN.com
 
Oh man, I haven't get flu shot for 5 years and start concern about could pass on me, however there's no status in my state.
 
A flu shot this year may not protect you from the flu strain in mexico - a man in Texas got sick with that strain and he was already vaccinated last fall. Also, we don't have enough cases to confirm the vaccine's efficiency but from what I read, the CDC is testing samples to see if the current flu shot will have at least some cross protection.
 
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